Specialist, Quality Interventions/QI Compliance (Remote in South TX)

About the position Responsibilities • Oversee and implement healthcare quality improvement initiatives and education programs. • Conduct data collection, reporting, and monitoring for key performance measurement activities. • Direct and implement NCQA accreditation surveys and federal/state QI compliance activities. • Initiate and manage provider, member, and community interventions to remove barriers to care. • Prepare for Quality Improvement Compliance surveys and other required quality activities. • Monitor and ensure timely and accurate completion of key quality activities. • Write narrative reports interpreting regulatory specifications and documenting findings. • Create and manage documentation to maintain critical quality improvement functions. • Lead quality improvement activities and discussions with other departments. • Evaluate project/program activities to identify opportunities for improvement. Requirements • Bachelor's Degree or equivalent combination of education and work experience. • Minimum 3 years' experience in healthcare with at least 1 year in health plan quality improvement or managed care. • Demonstrated solid business writing experience. • Operational knowledge and experience with Microsoft Excel and Visio. Nice-to-haves • 1 year of experience in Medicare and Medicaid. • Certified Professional in Health Quality (CPHQ) certification. • Nursing License (RN may be preferred for specific roles). • Certified HEDIS Compliance Auditor (CHCA) certification. Benefits • Health insurance Apply tot his job Apply To this Job